Impact of catheter ablation with remote magnetic navigation on procedural outcomes in patients with persistent and long-standing persistent atrial fibrillation

Qi, Jin; Pehrson, Steen; Jacobsen, Peter Karl; Chen, Xu

doi:10.1007/s10840-015-0037-x

Cited by 8 publications

(4 citation statements)

References 26 publications

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“…There is a 4.5% major complication rate from an updated worldwide survey of catheter ablation for AF . The result is consistent with other studies about the excellent safety record of the flexible catheter employed with RMN …”

Section: Discussionsupporting

confidence: 87%

Initial experience of a novel mapping system combined with remote magnetic navigation in the catheter ablation of atrial fibrillation

Lin

Pehrson

Jacobsen

et al. 2017

Cardiovasc electrophysiol

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Section: Discussionsupporting

confidence: 87%

Initial experience of a novel mapping system combined with remote magnetic navigation in the catheter ablation of atrial fibrillation

Lin

Pehrson

Jacobsen

et al. 2017

Cardiovasc electrophysiol

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“…A similar trend was seen in total procedural time which was 276.9±75.0 min for the whole cohort compared with 249.5±65.5 min for the corresponding subset cohort. These findings indicated the presence of a learning curve [26–28]. The lower mean fluoroscopy time demonstrated in our subanalysis of the most recent ablations from each cohort then showed an even greater difference between the RMN group (35.4±13.9 min) and the MAN group (61.2±32.6 min).…”

Section: Discussionmentioning

confidence: 50%

Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: Fluoroscopy reduction

Lim¹,

Toh²,

Loh³

et al. 2016

Journal of Arrhythmia

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BackgroundPercutaneous transcatheter radiofrequency ablation of atrial fibrillation with remote controlled magnetic navigation (RMN) has been shown to reduce radiation exposure to patients and physicians compared with conventional manual (MAN) ablation techniques.MethodsCatheter ablation for atrial fibrillation was performed utilizing RMN in 214 consecutive patients and MAN ablation techniques in 229 patients. We compared the fluoroscopy and procedural times between RMN and MAN catheter ablation of atrial fibrillation. Secondary objectives included comparing acute procedural success and short-term complication rates between both ablation strategies.ResultsFluoroscopy time was significantly shorter in the RMN group than the MAN group (53.5±30.1 vs 68.1±27.6 min, respectively; p<0.01); however, the total procedural time was longer in the RMN group (280.2±74.4 min vs 213.1±64.75, respectively; p>0.001). Further subgroup analysis of the most recent 50 ablations each from the RMN and MAN groups, to attenuate the RMN learning curve effect, showed an even greater difference in fluoroscopy time (RMN vs MAN: 53.5±30.1 vs 68.1±27.6 min), though a consistently longer procedure time with RMN (249.5±65.5 vs 186.3±65.6 min, respectively). The acute procedural success rate was comparable between the groups (98.6% vs 95.6%, respectively; p=0.07). The rates of acute complications were similar in both groups (2.3% vs 4.8%, respectively; p=0.16).ConclusionsIn radiofrequency ablation of atrial fibrillation, RMN appears to significantly reduce fluoroscopy time compared with conventional MAN ablation, though at a cost of increased total procedural time, with comparable acute success rates and safety profile. A reduction in procedure and fluoroscopy times is possible with gaining experience.

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“…This technology was described in our previous study. 8 In brief, this technique allows LA reconstruction to be established from the control room. The PV ostia were identified on the 3D LA map according to electrophysiological and fluoroscopic criteria.…”

Section: Anticoagulation and Ablation Proceduresmentioning

confidence: 99%

Efficacy and Safety of Atrial Fibrillation Ablation Using Remote Magnetic Navigation: Experience from 1,006 Procedures

Pehrson

Jacobsen

et al. 2016

Cardiovasc electrophysiol

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RMN-Guided Ablation for AF. Background:The objective of this study was to assess the procedural outcomes of catheter ablation guided by remote magnetic navigation (RMN) in a large cohort of patients with paroxysmal atrial fibrillation (PAF) and persistent AF (PerAF).Methods: A total of 726 patients (547 male, age: 58.5 ± 10.3 years) with symptomatic AF (61% PAF) were analyzed from a prospective ablation registry. Procedural parameters including pulmonary venous (PV) anatomy, left atrial (LA) volume, procedural time, ablation time, fluoroscopy time, total X-ray dose, and complications were assessed.Results: One thousand and six ablation procedures were analyzed. One-third of the patients (240/726) were ablated on more than one occasion, resulting in a mean of 1.3 ± 0.6 times for the entire group. When analyzing all procedures, the mean procedural time and ablation time was 134 ± 35 minutes and 2,130 ± 1,025 seconds, respectively. The mean fluoroscopy time was 5.4 ± 3.7 minutes. Compared to PAF patients, procedural time and ablation time were significantly increased in patients with PerAF by 10% (P < 0.001) and 19% (P < 0.001), respectively. However, fluoroscopy time was not increased (5.3 ± 3.5 minutes, PAF vs. 5.6 ± 4.0 minutes, PerAF, P = 0.17). The overall complication rate was 0.6%. One PAF patient experienced cardiac tamponade. AF repeat ablations by RMN significantly reduced the procedural and ablation times when compared with their first ablation times.Conclusions: AF ablation guided by RMN is safe as evidenced by a low complication rate. Fluoroscopy time was relatively short for both PAF and PerAF

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Impact of catheter ablation with remote magnetic navigation on procedural outcomes in patients with persistent and long-standing persistent atrial fibrillation

Abstract: Catheter ablation using RMN is a safe and effective method for PsAF and L-PsAF. LA volume could be a predictor of direct restoration of SR from sustaining AF by ablation using RMN.

Cited by 8 publications

References 26 publications

Initial experience of a novel mapping system combined with remote magnetic navigation in the catheter ablation of atrial fibrillation

Initial experience of a novel mapping system combined with remote magnetic navigation in the catheter ablation of atrial fibrillation

Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: Fluoroscopy reduction

Efficacy and Safety of Atrial Fibrillation Ablation Using Remote Magnetic Navigation: Experience from 1,006 Procedures

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